psychiatry – The Schizophrenia Diaries

The Last Month and a Half

It’s been a really wild month and a half or so.

To pick up from where I left off, I saw my psychiatrist in person for the first time in five years, just three weeks after our last phone call instead of three months. We again talked much longer than usual, and I brought some data on paper and my wife as a witness.

While we didn’t change my meds at this appointment, my psychiatrist was still seeing both manic and depressive symptoms, along with the usual (the anxiety, autism, schizophrenia stuff) and wanted to see me in person again in four weeks. In the meantime, she ordered bloodwork and urged me to call an eating disorder institute about starting therapy.

So I got on the bloodwork and the therapy intake, excited but also nervous at that point. I’d heard of Acceptance and Commitment Therapy for the first time recently at a conference, and started burning through related resources. Over my nerves, I had my first appointment with my new therapist about two weeks later.

That’s the point when I really think I started to see rapid change. My new therapist recommended I read the book Anti Diet, which I found myself reluctant to put down until I finished it a few days later. It was eye opening. Life changing, and I don’t say that lightly. My head was absolutely spinning with notes from the book and a few things I’d discussed in therapy, way too busy rethinking everything I thought I’d known about health to bother much with the eating disorder.

We talked about a lot of that, and more, in my second therapy appointment, also going over more of my history. And, she recommended me to the institute’s nutritionist.

Within a week after that, I met with the nutritionist for the first time. With an end goal of intuitive eating, she got me set up with a meal plan—three meals and three snacks per day at agreed upon times—meal, snack, meal, so on—no more than a few waking hours apart. And a way of selecting them—the Plate By Plate Approach. I would log the food and more—like sleep, exercise, symptoms, mindfulness, coping skills, and eating environment—in an app shared with her and my therapist: Recovery Road.

Since then, I’ve learned a lot about how my body is supposed to work. Even before the eating disorder, I’d never eaten like this, and, in many ways, I’ve never felt this good. It’s also interesting to be logging things for my team at least six times a day, instead of max once a week. There’s a lot more information to work with. At first, I thought I had time to do nothing but eat. When was I supposed to write? And I never felt hungry—the hunger cues we were working to reset were not there yet—and I rapidly found myself running out of food ideas. But I pushed through, and it got a little easier.

Going back, the very next day, I saw my psychiatrist again. We went over my bloodwork—a few numbers were out of whack, so she ordered another round so we could keep an eye on it. Still seeing certain symptoms, I went up on the new mood stabilizer I mentioned in my last post, though a med change might be needed if that doesn’t improve things. The numbers on my blood labs being off makes me nervous—though there’s not much to do but wait for more results—and the idea of a med change makes me nervous—even the dose adjustment tends to result in at least a rough day or two to power through. But it might be necessary.

And the next day (you see how these appointments add up?), therapy. More good thoughts discussed—including about all of the above—and we really dove into what my goals for treatment are.

One more therapy appointment, and then a week of travel threw off some of my new normal routines.

A few days after getting back, Monday, yesterday, I saw my nutritionist again. She was largely happy with my progress, and we discussed all of both of our questions from the first three weeks of logs. She offered me a few easy ways to spread my protein intake out a little more and maybe add a bit more variety, and assured me that pretty much all of my random symptoms were normal, which was a relief. And everything seemed easier than I’d made it out to be in my head.

Today I had that next round of bloodwork done, now waiting on results.

Tomorrow I’ll be back to therapy—the first appointment where we’ll starting weighing me in session, though I largely got a head start on an important part—not weighing myself outside of sessions. (I’ve only weighed myself once in the last month, down from multiple times per day.) The possibility of attending group therapy through the institute is on the horizon—but I’d already missed two of this eight week module when we first discussed it, and I knew I’d be out of town for another one, so we decided to wait for the next module at least. I also have appointments with my primary doctor and dentist, and more appointments with my nutritionist, therapist, and psychiatrist coming up.

It’s a lot of work, but things are definitely changing. I just wanted to illustrate my first steps and tell anyone who needs to hear it that recovery is possible, and it’s about so much more than the numbers.

(Also, I obviously found time to write in between all the eating.)

Evaluating My Care Team

I mentioned recently that my care team consists solely of my psychiatrist, whom I talk to on the phone, on average, for about three minutes once a quarter. In a way, that suited me well for a long time. I was, overall, satisfied with my mental health. Besides, sometimes I feel like I spent half of my teenage years in medical offices and waiting rooms and cars going to and from them. For good reason, but it felt so freeing to not live my life around appointments that satisfied was good enough for me to not seek more help. I was burnt out of finding and seeing professionals who treated things like burnout.

Lately, though, I’ve felt less satisfied. It’s not that my mental health has overall gotten so much worse, but I’ve hit a few speed bumps, come up with a few questions, and realized I really don’t have much of a team to keep those speed bumps from becoming more, to answer those questions. And, maybe, I’ve rested enough to recover from my therapy burnout.

For example, I wrote recently about a mixup that resulted in me missing doses of my medication, Seroquel. I feel like since then, the road’s been a little bumpier. Is that why? What happens when you go abruptly, briefly off Seroquel and back on it? How long should you expect to be off track for? Could a different antipsychotic be better? Would another med boost my mood and energy, or help the eating disorder symptoms? I was doubting the ability of one woman to answer all of these questions for me in three minutes over the phone, over a month after the fact.

My psychiatrist also tends to leave decisions in my hands, with sometimes minimal guidance. I appreciate her valuing my opinion and not shoving me down a path I don’t like—as dozens of psychiatrists did before her—but I’m also not the expert. The calls, by necessity, can feel very decision focused, with no room to really explore and explain options, when she’s overbooked, already late to my appointment, and I know I’m making her even later for the person after me.

I wasn’t sure she even really knew about the eating disorder concern. I definitely didn’t want a med change based on it, until recently, when I began to consider it. (There aren’t really medications for eating disorders, even though meds are often involved in eating disorder treatment.) At times, when our phone call finally came about, I thought I’d largely left the food issues in the past. Or, I’d start to talk about it, only to feel like it got glossed over.

Seroquel is somewhat notorious for making you gain weight—like many antipsychotics, and psychiatric medications in general—and messing with certain blood levels. After ordering routine bloodwork to check in on that, my psychiatrist asked if I’d gained any weight on Seroquel. Thinking that a good time to raise my concern I might be becoming anorexic, “No,” I said emphatically. “In fact, I’ve actually lost some weight, and I—”

“Oh, good,” said my psychiatrist, moving on, and not noting from my chart that I didn’t have much weight to lose before becoming underweight in BMI, nor seeing what I looked like.

That was about a year—strong maybe fifteen minutes of phone call—ago now.

Part of me just wanted to start over. Lay everything out for a fresh audience who might offer more guidance. I even reached out to a few possibilities, with no success. There was a reason I landed with my current psychiatrist and stuck with her for about seven years total—despite everything I’ve said that may sound negative, she’s the best one I’ve had.

I’d drafted the above (which I’ve since tweaked) right before my most recent appointment with her. (Sometimes life happens too fast to blog about.)

Our last appointment was different. I decided, in possibly a last ditch effort, to take all the time I wanted, ask all of my questions, insist on more information, and emphasize all of my concerns. My psychiatrist, getting the memo, asked to see me in person in three weeks, instead of on the phone in three months, and put me on a new, quick acting mood stabilizer to help my mood and such, which has thus far been really good. (According to the instructions, I took half a tablet for five days, a full tablet for five, then a tablet and a half—the long term dose—but I feel like it’s a bit much, making me a zombie in the mornings, and restless at other times, and while I gave it a few days like the other dosages, the best dose seemed to be in the middle, and I went back down.) I feel like I got my answers and information, but new questions that could not be answered immediately took their place.

She was very concerned by what happened when I went off Seroquel—it sounded a lot like a manic episode to her (not surprising), but, more surprising to me, it apparently isn’t a typical withdrawal symptom. How I’d felt since, she said sounded a lot like a mixed mood episode, something I hadn’t considered, but made sense. So the new question—unexpectedly, to both of us—is if I might be somewhere on the bipolar spectrum. As I do research… it does, in a way, line up, explain a lot. But in some ways, doesn’t. There’s a very good case I’ve had depression for a long time, maybe on again, off again—though the psychologist who gave me my diagnoses made the case that all of my “depression” symptoms, including self harm and a suicide attempt, came back to anxiety. It’s the mania idea that’s newer. And we don’t have a lot of definitive symptoms to go off of right now, especially since Seroquel—which I’ve been on for years as an antipsychotic—is also, coincidentally, a mood stabilizer (just not doing quite enough for me). Psychosis, as always, complicates things. (According to some professionals, you can’t actually have both bipolar and schizophrenia—you would always be diagnosed with schizoaffective disorder, bipolar type.)

The slightly older question to me, the food issues, she wants to address in person with a scale and bloodwork. I find it frankly unlikely I don’t have “at least” atypical anorexia right now, which is not technically a type of anorexia, but a subtype of OSFED (Other Specified Feeding and Eating Disorders), formerly EDNOS (Eating Disorder Not Otherwise Specified), because, again, the diagnostic process is just so much fun. It’s also possible, given the blurry line between atypical anorexia and anorexia (the line being whether or not you are underweight, except that the meaning of underweight is no long specified, and it is commonly observed that the same patient could be diagnosed with either one depending on the doctor), that I could be diagnosed with anorexia, being below any calculation of my ideal weight, but not at an underweight BMI. I am also aiming to recover from it, which would take it off the list, so to speak.

So, questions left to answer.

Meanwhile, I’m also really considering trying therapy again. It’s not actually a lack of effort that’s kept me out of therapy. I bounced in and out—mostly in—therapy for the better part of ten years, seeing dozens of therapists, until just over two years ago. Finding them was hard, getting an appointment was hard. Some of them were just bad. One was a pedophile. (Didn’t touch, but immediately started asking questions about my then nonexistent sex life—given I was sixteen—after my mom left the room.) One nearly got violent. One went totally nonresponsive when important paperwork was involved. There were inpatient ultimatums and an endless stream of, “I can’t help you.”

Finally, about eight years ago, 2015, when I was seventeen, I started seeing who ended up being my last therapist, whom we’ll call K. I got along really well with K. But she was an MFT—marriage and family therapist—who wasn’t officially qualified to treat psychosis. Even when that got officially approved, she still didn’t magically know anything more than she had before. Plus, while she was open minded, there were other elements of my life she just wasn’t well educated on, like queerness and the kink community.

Shortly after I began seeing K, she referred me to D, a psychologist with a PhD, who could officially, finally diagnose me, which meant I could get then important paperwork, accommodations at the community college I was set to start at (an ultimately doomed endeavor).

I saw D for diagnostic purposes, but I really liked her, too. She was much more equipped to help with psychosis, and she had a better grasp on other elements in my life. But I was still doing some good work with K. So, while unconventional, since they both worked in the same office, we came up with a plan where I’d continue seeing both of them, on alternating weeks.

Things seemed to be going pretty well for several months, but then, one day, D vanished off the face of the earth. We couldn’t get a hold of her directly; her office staff stalled, denied, ran us around, or also vanished. Even K didn’t know what was up.

Deep down, I think I knew the truth all along. But years passed—I started seeing just K, every week again, including via video chat during my ultimately brief stint in Boston. At times, I considered stopping therapy. I liked K, still, but the gaps D had filled remained empty, and overall, things seemed good.

Then Dad died. And when you’re already in therapy, and you find your father’s ten day old corpse in his house, you call in the big guns. Or, you face why you can’t call in the big guns.

K confirmed—shocked no one had told me around the time she’d found out—D had passed away, all those years ago. She was perhaps my father’s age, brushing sixty.

Great. Best therapist I’d ever had, dead well before I’d been seeing her for a year.

But I continued with K, for another crucial, tumultuous year. PTSD. Increased psychosis. Probate court. Becoming a landlord. Buying a home. My grandmother’s death. Getting engaged. And, of course, the beginning of COVID—relegating us to video chat once again. I’d been off meds for about two years—taking a total break from my psychiatrist while things were good—but K encouraged me to return to her, and to go back on meds; it was, at that time, ultimately, a great call. Things improved again.

So, for largely the same reasons I’d considered before, I stopped therapy, focusing on meds and lifestyle changes—liked I talked about in a recent post—because things were pretty good, and the elements of my life K was less educated about were becoming more and more relevant—in good ways, but hard to totally talk around in therapy.

I’ve tried, both before, with K’s help, and after stopping therapy with her, to find a new therapist, to either fill the gaps or take over. But it’s hard. My criteria are kind of demanding—all of the issues of before, plus more. I either never hear back, or get another, “I can’t help you,” or they’re just not available. And according to Psychology Today, D is still taking new patients. Hit her up. If you have a Ouija board.

I’m trying again, though. So far, crickets. But we’ll see.

I think even seriously thinking about therapy has helped. I want to show this new professional that I’ve done my research, looked inside myself, made the lifestyle changes, even worked on the meds, that I’m ready to go deep. I try to imagine the advice I’ll get, and act on it, the resources I’ll get, and consume them, the questions I’ll get, and answer them. I also don’t want to waste time, especially on spending months working through the obvious that any professional could give me, only to find out that we’re not compatible to deep dive together, and I need to reestablish basics again with someone new to move forward.

I’ve also made such changes and reached out to several doctors about facets of my physical health—in case some of these headaches aren’t anxiety, but needing glasses, for example—but so far, crickets, and a few of the classic, “I can’t help you.” We’ll see.

I suppose only time will tell.

A Few Weeks in the Life

January 21st.

There have been a lot of ups and downs in the last few weeks.

Shortly before New Year’s, I ran out of my antipsychotic, Seroquel, due to problems having it refilled. My wife had gone to the pharmacy for me since she was in the neighborhood. The pharmacy said the psychiatrist never sent the prescription over, my psychiatrist’s assistant (whom I finally got a hold of) said she had, and my psychiatrist—whom I talk to on the phone for a few minutes once a quarter—was out of office. There hasn’t been anyone else on my care team in quite some time. In the end, I missed two of my typical daily bedtime dose (went three days between taking it).

Without the Seroquel, I didn’t sleep worth mentioning, and was basically awake for sixty hours straight. During that time, I felt great. I went about all of my waking routines as usual, perhaps with extra vigor, catching up on my monthly writing goal, and going to a previously scheduled experience gift of a guided painting night from my mom, with her and my wife. Despite increasing psychosis symptoms (and the complete lack of sleep), I began to feel that maybe there was no point in going back on the meds at all. In reality, I probably had something like a brief, withdrawal induced (hypo)manic episode of some kind.

In the end, my psychiatrist’s assistant got a hold of my psychiatrist, who sent the prescription over again. Now that I was definitely in no state to drive, my wife went back to the pharmacy. They still said they didn’t have it. She called me to troubleshoot some more. In the end, it turned out she didn’t give the pharmacy my maiden name (and my psychiatrist/pharmacy seems to switch between my maiden and married names at random). I always give both names, and thought she’d observed this and would do the same (or at least the pharmacy might prompt her). In any case, problem solved. I went back on Seroquel and tried to bank extra sleep.

Yet, after that, my mood, focus, symptoms, and energy plummeted. I became more anxious and moody, feeling self destructive. The increased psychosis symptoms continued; there’s Farrah, the recurring dog, teleporting around, and a song I was listening to, my father’s corpse, gibberish voices, more.

I suddenly spent hours of my free time curled up on my office floor crying for no apparent reason.

I relapsed and cut myself for the first time in over a year and a half, after a lot of resisting the urge.

I couldn’t (can’t) write for long, no matter how clear the words are in my head. After finishing up my December goal on New Year’s Eve, despite a lot of time sitting and staring at my notebook, I haven’t posted anything since, my January goal deadline looming.

I took two days off from my usual routines (though I taught a class in that time), the first time in over a month I did so without solid reason (holiday, travel, someone else’s cancellation).

During the time I was off meds, I rapidly lost weight (not a lot, given that it was three days, but noticeable to someone who habitually hops on the scale several times a day, even after moving it to a bathroom I don’t go in much). I’m currently theorizing that the main reason my BMI is still low-normal and not underweight is because of the Seroquel, normally famous for making you gain weight—though I’ve lost some weight while on it, and am below my ideal weight, I am not losing at the rate I would normally. And that gave my eating disorder symptoms—primarily calorie restriction and overexercising—new life. About a month ago, I’d thrown out a crucial part of the enema kit I was abusing, sometimes multiple times a day, to “purge” in an attempt to quit; in stomach pain (unrelated), I acquired a new one, used it the once somewhat legitimately, but also very aware of my inability to quit with the kit around. After one more semi legitimate use, I gave the crucial piece to my wife and asked her to hide it, but later found it while she was out (Monday), and used it again.

(I was supposed to be running a routine TNG meetup event that night, but for the first time since I started the group—about a year and a half ago—I decided, day of, that I was not up to going, and she was my backup host.)

I also did a lot of eating disorder related research (and general media consumption). I read Almost Anorexic and Elena Vanishing.

I’ve still hosted the other TNG meetup event, and taught both virtual classes as scheduled so far this month.

I took another night (Thursday) off from my usual routines.

Yesterday, delusions joined the hallucination upswing. Why the fireplace would try to poison my dinner after failing to explode, even though I saw the smoke of it, I don’t know. Based on a dream I’d had, voices taunted that I was responsible for the long ago suicide of a then long ago former friend-quaintance. In a confused state as my wife tried to convince me to sleep it off, to try functionality again in the morning, I told her she was very pretty, and asked her whom she was, and where she had come from, picturing something like Farrah’s Void.

“Uh… Queens?” she said.

“You’ve met the queen?” I asked, enthused, completely misunderstanding, yet also apparently with it enough to think that if you’d met the Queen, you were someone important, even though I didn’t know whom my own wife was, and if you’d asked me the Queen of what, I probably couldn’t have told you.

Later, she told me, “You should go to sleep,” and I asked her if it was nice there, and if it was in Queens, and for directions. (I had no memory of this in the morning—I abruptly remembered it several days later while out on a walk, and started laughing, much to the confusion of onlookers.)

But today—another morning off—I feel at a bit of a loss as to why this is (still) happening, or what to do next.

…

It’s January 22nd now. I took last night and this morning off from most of my daily routines again. To be fair, both were spent on nice, special occasion family things, and I caught up and got back on track before dinner and my evening routines today.

…

January 23rd. The gibberish voices returned last night. I’ve been on track, though, and I’m experimenting with ways to rest more, stress less.

I still can’t seem to write more than a few sentences at a time, even though I have a lot that seems ready to go in my head.

It’s not even that I’m just unfocused. I’m not starting to write and then going to scroll the web intermittently instead. I open my notebook, or I open the document, and then I blink, look at the clock, and maybe half an hour’s gone by, there’s nothing on the page, nothing in my browsing history, and I have no idea what just happened. I seem to just be sitting and staring.

This morning, I thought I’d try time tracking to figure out where in the world that time went. Every now and then, every few months or so, I track my actual time in detail for about a week, to make sure it’s going where I want it. Normally, it is.

Today, at 11:05, I took a break. I had a snack and I went on the swingset in the backyard. At about 11:35, I wrote that I was about to start writing. I felt inspired. Then I blinked, looked at the clock, and it was 12:15. Nothing in the document. Nothing in my browsing history. No clue.

Shortly after writing the above, I mentioned the time tracking gap to my wife, who suggested I work at the extra desk in her office so she could see what happened/nudge me before I “blinked” and it was forty minutes later.

I sat down and opened up my notebook, and then apparently stared into the void. I remember more of a perception of time passing, but not much else. She nudged me at some point, but not much happened—minimal movements/speaking/response, almost catatonic. Eventually she got me to the bedroom for a nap, a little after 1:30, and I proceeded to sleep until almost 4, having strange, half awake feeling dreams and waking groggy, but feeling my recent normal between the missing times.

I have no idea why I’m so tired. I’ve tried shifting my wakeup time twenty minutes later; I’ve done a lot of sleeping in lately; I’ve slept well and plenty overall. But I did feel like I was about to pass out, stumbling my way down the landing to my wife’s office earlier.

…

January 29th. I took the rest of the 23rd, and the 24th, off, then got back on track. Writing is going better—slow but steady, though I still haven’t posted anything—and I feel better overall. My energy’s up. Still feeling kind of overwhelmed as certain deadlines loom. Eating Disorder Mode has largely continued, unfortunately, with near daily enema purging, and falling into chewspitting again for the first time in two months or so.

But I taught a class yesterday, with lots of people and lots of participation, and got other social time in, and that always perks me up.

I’m tweaking my schedule for sustainability. I’ve shifted my wakeup and lights out time slightly later to better match my natural rhythms. Closed an unproductive gap and removed an admittedly unproductive item from my routines, but created a gap at night, after my wife goes to bed and my electronics get turned off, to get some alone time, offline, to decompress before Seroquel and lights out, maybe do some writing (and she gets her own gap before I wake up). Finally admitted that consistent grocery shopping—having to feel up to driving, physically shopping, the sensory experience of the store, so on—is still often a Lot for me, and handed the general shopping to my wife at her nudging (actually, a lot of this was her idea), though I’ll still make the list and handle all the rest.

I’m hoping I’m still just a bit off kilter from the med mix up, and those changes will help both short and long term. If not, I still have my psychiatrist appointment in less than two weeks to discuss more.

I’ve gone back and forth on whether this is a blog post, a failed start at an incondite blog post, or a little log I’m keeping for myself (outside of my usual journaling). As I read it over, it sounds like a pretty basic life update for a mental health blog, and while that’s not necessarily bad, it’s not quite my usual style, either.

I’ve talked to a few different people recently about balancing different parts of my public image. Like almost anyone, I’m more inclined to show off my wins online than discuss the hard, or even, for me, mundane, parts of life. As someone whom people tell me they think of as an educator, a leader, a role model, it’s especially tempting to brush over things like mental health symptoms when in front of a larger audience. And I don’t like to worry anyone.

But… I also write and teach on mental health, so at some point, it’s weird if I’ve never actually discussed or displayed symptoms in public as they happen, as part of life, in a sometimes unpretty way—only smoothed over, as part of topic centered pieces, after the fact.

And I think it’s important for people to have a real reference for day to day, honest, non sensationalized mental illness, from inside of it, especially for the conditions shrouded in stigma.

So, here it is. A few notable, but not entirely unusual, weeks in my life.

Kabbalah for Schizophrenics (Or: Spending Too Much Time in Atziluth)

Around the beginning of August, after some dabbling in it, I unexpectedly got really into tarot reading. Down various related rabbit holes I went, often trying to generally get (back) in touch with my skeptical spiritual side, with my cultural roots, with the philosophies that had called to me, and maybe add a bit of witchcraft. From sigils to synagogue to Stoicism, I explored.

This month, I landed somewhat close to my cultural origins and, via looking for tarot resources through familiar venues, ended up attending two Zoom classes at least half about Kabbalah.

Kabbalah is an esoteric method, discipline, and school of thought in Jewish mysticism. It’s really fascinating, if kind of mind melting, stuff. Kabbalah’s not really a primary Thing of mine, and I’m far from an expert (I seem to be setting up camp somewhere in witchy Stoicism), but it gave me a new spin on my deck (A. E. Waite) to consider, and other things to ponder.

Which brings us to the actual subject of this post.

In Kabbalah, we have the concept of the Four Worlds. Put simply, Atziluth is the world of the divine, the spiritual, of wisdom and the big picture; it is precreation, things not yet taking shape. (In tarot cards, it correlates to the suit of wands.) Briah (in tarot, cups) is the world of feelings and morals, of the first stages of creation, where ideas start to take shape and take up space, just start to ossify. Yetzirah (swords) is the world of planning, thoughts, mental constructs, and refinement of ideas. Assiah (pentacles) is the world of the physical, of primality, of the created, of action, manifestation, of the day to day mundanity we often call reality.

Each of these worlds has its place. To stay in Assiah all the time would be, well, rather simple, to the point of (dare I say) boring. But to neglect it is to end up impoverished and (eventually) physically die. To never visit Atziluth is to never connect with your highest self, to never gain a divine view and wisdom, to never go beyond.

This may sound a lot like Maslow’s hierarchy of needs from psychology to some people (and I think you’ll find a lot of spiritual/mystic concepts sound a lot like something from psychology, and as a bit of a skeptic, I like to stick close to those, viewing tarot cards as something like thought prompts). While you can jump around the hierarchy, things tend to go better with first things first: physical needs met now, security in that long term, then the emotional/mental: relationships with others, love, and the security that comes with that, then reaching for achievement and esteem, and finally self actualization.

As I revisited these concepts, I hit on a way of phrasing a large problem of mine: I spend too much time in the world of Atziluth.

This may sound lofty and pretentious, but it’s a real problem, and I think frequently, for me, what sounds pretentious at first is actually a mental illness thing. If you’ve seen the phrase I reject your reality and substitute my own on a coffee mug or tee shirt, it can sound pretentious at first read (and it’s often a joke), or, if it’s a little too true, like a little thing medical professionals like to call schizophrenia.

In any case, spending too much time in Atziluth. This manifests for me in several different ways.

I typically feel a large disconnect between my mind (more accurately, all of my nonphysical self) and my body. I feel more at home deep in my thoughts than in my body, and I frequently view having any physical form—being pulled back into Assiah—as a required nuisance. (My ascetic leanings—see Stoicism—don’t always help.) It’s not a matter of appearance or fitness or health—even my idea of the most perfect human form would still make me feel this way.

Because of this, I unwisely tend to neglect or even abuse my physical self, view it with disdain—why can’t it keep up with what I consider the rest of me capable of? Imagine what I could do, it wasn’t for all this sleeping and eating and drinking water, and what happens when I don’t do those things. In the physical world, this looks a lot like poor self care (though I’ve gotten a lot better on that front), active self harm (same improvement here), and symptoms of anorexia (this is the big one, currently, and it has other roots in my psychosis).

There’s an irony in this. Oh how wise and intellectual, spending too much time in Atziluth, I ponder, chew-spitting cookies and eyeing the enema kit again because I resent needing calories to manifest my ideas in the physical world.

My wife and I have had several conversations that contributed to the formation of this post. She basically posited that if Atziluth is where ideas are first conceived and creativity runs limitless, it’s kind of like that’s where your ideas live, and you have to visit to retrieve them. Some people struggle to visit for long, or to find much there, or to bring that back with them. But me—on the bright side—I seem to have an almost unlimited pass, and basically whole books up there ripe for the picking (typically manifesting as dissociative/maladaptive daydreams on the border of hallucination), and after a brief run back through Briah and Yetzirah, (if I’m properly medicated) I manifest them into reality/Assiah with apparently astonishing speed (publishing eight full length books among other writings in the last—less than—two years.)

I told her a story about when I was a kid. I had an imaginary friend who was a witch. In hindsight, I was a little too old for imaginary friends and a little too convinced of her having some form of existence (hello, early warning signs of schizophrenia?), but in any case, she was a witch, and also a ghost, a wise girl about my age, and she lived with her ghost family under my house. (There was no basement or anything, but, well, they were ghosts, so the fact it was all dirt under there wasn’t an issue for them; they had a ghost house.) She was going to teach me how to be a witch. As part of this, I had to visit a ghost library under her house, and read the appropriate texts on the subject. The way for me to visit was to close my eyes and visit it in my mind. And I did. At night, I’d go down there and read the witchcraft textbook of the week, sometimes writing things down in the morning. (However, my daytime practice results were iffy, and at some point, I stopped engaging with… whatever that was.)

But I’m in my witchy phase again—and I don’t think it’s just a phase this time—I have schizophrenia, and I still seem to have a library in my head to go visit, so, y’know… yeah, I’m not sure how that sentence ends, either. (Incidentally, due to a frankly royal screwup by a medical professional yet to be determined, I completely missed my last dose of my antipsychotic for the first time in almost two years—hey, have we heard two years recently?—and I am not properly medicated today, so if this post is total nonsense, please bear with me.)

But, too much time in Atziluth also has some pretty big social effects, that look a lot like what we call negative symptoms of schizophrenia, lack of normal functions. Or, I’m a pretentious space case.

I struggle with spending too much time grounded in the physical world (eventually, my brain will rebel and dissociate, rendering me flat or nonverbal), and struggle to find joy or stay engaged in what most people consider the mundanities of friendship—playing games, watching television together. I prefer extended freeform conversation focused on ideas, or coexisting in the same space as we both engage with our own ideas in some way (the adult version of parallel play, frequently associated with autism, which I also have), visiting Atziluth together, in a way, but most people do not. Relatedly, I also just don’t have much motivation to interact with people (outside of larger groups) I’m not already very close with, who are more compatible with that kind of interaction; I prefer my friends to be more like family, and I want more of that (though I’m grateful for the people I have), but struggle with getting to that phase with new people.

I swear I’m still an extrovert, overall (I used to be an introvert)—I get my energy from the kind of social interaction I prefer—but I’m an atypical and mentally ill extrovert who struggles to get that preference met. So, sometimes, I lack the energy to try to get that need met (have you ever been just too hungry to cook?), or to engage at all, and prefer for the moment to just play with my ideas and visit Atziluth by myself. (Which, incidentally, looks a lot like workaholism, since, when generally properly medicated, I’ve made something resembling a career out of it, instead of getting stuck in Atziluth the whole time and staring into space blankly).

None of this is a major news flash, just a new connection, a new way of thinking about symptoms (although, reading over this post, I don’t think it’s an explanation suited to casual conversation).

Schizophrenia can be almost as hard to pin down as Kabbalah, so new explanation frameworks that make any kind of sense to me, at least, are something I always welcome.

Why We Need Diverse Stories (A Letter I Wrote in a Dream)

When I was in high school, I started writing my own happy endings.

I was fifteen, in love with another girl, drowning in homework, developing schizophrenia, and generally more confused than ever.

Then came yet another English project, which included doing research on a chosen subject and then writing about it in ten different genres/formats. A Multi Genre Research Portfolio of Fun, if you will. Or, the MGRPOF. There were multiple all nighters and trips to craft stores involved in this Portfolio of Fun for most of us, and it was due immediately after an annual, weekend long field trip for my major that was basically a sacred tradition, making many of us in the program, including me, miss it.

Still. Not yet out, I dared to push the envelope a little and selected my topic: mental health and LGBTQ+ young adults.

I researched. I discovered the Butterfly Project, years before I needed it. I read Raising My Rainbow by Lori Duron (and keep up on that family to this day). I read countless articles.

For one of my genres, I selected the short story, but instead of the one or two pages required, I ended up writing sixty, and split it into sections. Each section ended in a piece that fit into that same story—though the project didn’t have to all go together—in another format option offered: a love letter, a diary entry, a speech, a poem, a news article.

And through this portfolio, I created a future I could see myself fitting into. Here are two young women in college, one struggling with depression and being openly queer despite her dubious and religious upbringing, the other closeted and questioning, too anxious to commit and come out, still thinking of the straight girl in high school who got away. Here is how they fall in love: the close friendship typical among young women that goes further and further. Here is them dancing together when their male dates vanish, here is them taking on stigma hand in hand, here is the kiss they share at a pride rally when everything feels okay.

Here is a world for me beyond a husband, two point five kids, and a dog.

My final submission was all arranged together in a scrapbook. I still have that scrapbook. It is not an archive of my past, but an archive of the first future I saw for myself filled with that kind of love, after I started having so many questions.

And now…

I don’t have a husband, or two point five kids, or a dog. (Well, there’s always the imaginary one.) I have a wife, and two cats (and I’m petitioning for number three), and a house on the end of a cul de sac with a metaphorical white picket fence, and a white SUV, and a conglomeration of things I do, that I love, and that aren’t such shocking choices; yet there was a time I couldn’t see this future coming.

And still, sometimes, I seek out my past. I seek it out in the young adult section of the library that is, both slowly and all at once, catching up.

Here are stories about hopeless crushes on queer Internet friends that you’ve never gotten to meet, but rush home to talk to, text under the table in class. Here are stories with teenagers running to therapy appointments after school, doing homework in waiting rooms, or running to synagogue, doing public school homework under the table with Hebrew papers on top, and asking the Rabbi the hard questions; is it okay to be gay? What if you don’t believe? Here are stories with girls falling asleep on each other on the bus, holding hands while they walk home from the bus stop and wondering if it means what they think it means. Here are stories with practice kissing and stolen glances at your best friend while doing homework together. Here are stories about Googling words you discovered in fan fiction erotica, that sound a whole lot like you.

Here are stories that make me feel like any of it ever made any sense, enough sense that maybe someone else could’ve gone through it, too. Here are the stories I put in my read in color Little Free Library, so that everyone else can read them, too.

Here are the stories I write, for the people who need them most. Readers tell me over and over how they cling to my characters that resemble them, because they’re not cis or straight or vanilla or monogamous or abled or neurotypical or White or Christian or male. How it feels to be seen, to see themselves, past, present, and future, to be represented.

And that’s why we need diverse stories.

But sometimes even I wonder if we still need them. Are there enough now? Look at the Internet. Look at the world. We’ve come so far. So many things are more visible. Yet we’ve slipped back so much, too. And are stories worthy? Or should all that time go to other activism?

But then my mind provides me a memory: sitting at a pancake brunch with an elderly family member, glowing, radiant, as she tells me she is so glad to have lived into her eighties to finally get to watch a few characters who are like her on primetime television.

And then I stop asking silly questions, pick up my pen, and get back to work.

Schizophrenia in Creativity and Productivity

(Note: This post has been adapted for The Schizophrenia Diaries, but is mostly a repost from A Productive Hannah.)

In some ways, I honestly don’t remember much around the origins of this blog. It was summer 2020 (and let’s face it—who has a great memory of summer 2020?). I wasn’t yet back on antipsychotics (by weeks to months), I was facing a pandemic, a world on fire, the recent death of my grandmother, and the one year anniversary of discovering my father’s death (leading to PTSD). I was mostly lost in a creative haze, spending hours every day on the swingset at the nearest park in heat over 110*F—dissociatively daydreaming up new plotlines with a song on repeat—or curled up in the fetal position on the floor in my office, near catatonic and hallucinating. It was A Time.

However, it was one of the most prolific periods of my life. After spending most of a year after my father’s death pouring emotions into Contrivance, my primary fiction project of almost a decade, instead of sleeping at night, I was (mostly) taking a break from Contrivance’s dystopian doom and gloom that now seemed all too realistic, focusing on what I thought would be a quick, simple side project to perk me up, which eventually became the I’ll Give You series, my first real foray into erotica, which now has four books published and more in the works (spoiler alert: not a quick, simple, or always cheery side project after all).

And, I started The Schizophrenia Diaries, after having casually maintained a different blog for about a year. My first post wasn’t about writing or creativity at all. It was about Farrah, my so called schizophrenia tamagotchi, my recurring puppy hallucination, who had recently come about. From there, I wrote about all manner of mental health related things for about six months, essays as ideas came up, then floundered a little on what to do with the blog. I was back on meds, and out of therapy. Vaccines were on the horizon. The election was over. I’d recently gotten married and published my first book. Things were good, and while I was grateful, I wasn’t sure what to write about now; without acute symptoms to reflect on, I got a little lost. Things on the blog slowed down, and I didn’t make a post in 2021 until mid April.

I had thought about it in the meantime. I didn’t really want to abandon the blog. Schizophrenia is highly stigmatized and misunderstood. Stories of schizophrenics are rarely told at all, and even more rarely do we get to tell our stories ourselves. I felt it was important—part of something bigger than me—to write on it. But, the blog was neglected when I was doing well, which gave me mixed feelings on it, and I wasn’t sure what I had left to say. I thought that maybe I needed more of a theme, an angle, something to ground the project besides processing symptoms as they arose.

I reread some early posts on the blog. What grabbed me was my last post before things really slowed down, a September post before two more that December and then silence for four months. (Note: I know I made some posts that were later taken down, so there may be minor inaccuracies here.) The post that grabbed my attention was about psychosis as a part of my writing process, how my schizophrenia and my colloquial tortured artist syndrome intertwined, about how my psychotic daydreams fueled my writing, how the darkness of the things I tended to write about both contradicted my triggers and calmed me down, and so on.

That. That was my angle. Because even when my symptoms improved, they were still there—and the most cohesive way I could talk about them was through how they impacted my creative processes. No matter what, I was always writing. I always had that to talk about.

With reframing and revising, things picked up on the blog again, even when my mental health was largely okay.

I talk a lot about psychosis and creativity—but what about psychosis and productivity, one of my other passions?

I mentioned that one of the worst time periods in my life as far as symptoms was also one of my most prolific—how does that work?

There’s definitely a balance.

After having made it without meds for about two years, when I started again, the first night I took Seroquel—well, firstly, it knocked me out so unexpectedly hard and fast that I fell out of my chair at my desk—the change was immediate. For a few days, I was basically symptom free. It was almost like I didn’t have schizophrenia, overnight. I realized how bad my sleep had been—which didn’t help anything. It had been so bad, I realized, as Seroquel knocked me out at night, I wondered if I could chalk almost everything that year up to sleep deprivation, the miracle of Seroquel to the miracle of sleep, more than its use as an antipsychotic.

But during those few days, I felt… conflicted.

When Farrah—the dog who’s not real, mind you—found out—when I decided—that I was likely going back on meds, she worked those puppy dog eyes real hard. Why would you want to get rid of me, Mom? I tried to telepathically communicate to her that as far as I was concerned, I was happy to keep her, if I could get rid of the corpse and the blaring music and the black blobs and the flashes of light and the white noise and the maggots and all of the other issues. Later, I came to realize that Farrah—this is my current working theory, at least—represents the part of my mind that wants to be psychotic, freely creative without the limits of pesky reality.

During those first few days after Seroquel, I felt… a little empty. Numbed. Better than I had in months, maybe a year, in certain ways, but… something was missing. My daydreams were missing, my fiction fuel—they were back in the normal human range. It was like watching a movie on a decades old television versus watching it in IMAX 3D. I couldn’t get reality to go away entirely even when I tried—and normally, I didn’t have to try; in fact, normally, I had to fight to get back when my alarm went off telling me it was time to make dinner or something, nudging me out of daydreams.

Despite how well I seemed to be doing, I wondered if I might lower the dosage.

But, my body quickly adjusted. A few days later, I could sink into my daydreams that deeply again, but I had some more control over starting, and I didn’t have to fight quite as hard to stop. Other symptoms stayed improved but didn’t vanish. And, not lost in the daydream stage forever, it was easier to get out when I wanted, to grab a pen, and start putting daydreams on paper. But things can get pretty bad—lots and lots of time lost in fantasy on the verge of hallucination, not quite in my control—before I totally stop getting to the part where I write them down. After meds, I was overall less purely prolific, except for a few really, really bad parts of that prior year or so.

However, that was just about fiction word count. I thrived in other areas like I never had before, where psychosis was mostly a burden. It’s not much of an advantage as far as being a housewife, a landlord, a butler school student, an alternative sexuality educator, a group organizer, or even a nonfiction writer (overall, my blogging writing has picked up since). In fact, those last three non writing areas were all things I seriously picked up within a year after meds for the first time. I found more balance. I wrote a little less fiction at times (we’re still talking frequently upwards of 25,000 words per month), but I did everything else that was productive a little more, more than enough to fill the gap.

Even my fiction did pick up a more productive edge, though. Things other than sheer word count matter for that. Pieces actually got finished, typed, edited, formatted, and posted, in a largely linear way that didn’t contradict itself, with improved quality. More than the three people closest to me began to read it.

I see this psychosis equals creativity but lack of balance thing in my past, too. My schizophrenia was early onset. My symptoms first appeared around my fifteenth birthday, mid ninth grade. I was producing writing like crazy—even winning multiple rounds of National Novel Writing Month per year (this means writing upwards of 50,000 words in a month—many times, I got closer to 100k). However, school wasn’t going so well. I dropped out before the end of tenth grade. Now, I see why I was writing fiction like crazy while failing to turn in five-hundred word essays that weren’t word salad gibberish, or be non catatonic long enough to show up to class, or finish taking a test without yelling at demons only I could see.

So are there pros to schizophrenia for productivity, for me, as a fiction author? Yes. In other areas? Less so that I see right now, though I frequently joke that my general, various anxious neuroses are the edge that keeps me moving so quickly, lest I die tomorrow. Are there cons? Of course. Many. Still, I wouldn’t quite hit the cure button, for myself.

It’s just, as many other things are, about balance.

My Most Common Hallucinations

A very common first question when talking about psychosis is, “What do you hallucinate?” It’s not an incredibly simple question; it’s kind of like asking someone, “What do you see, in general?” Of course, it varies person to person, but here are my most frequent hallucinations, in no particular order.

Voices, Chatter, Noise

Voices saying specific things, or general chatter around me. The latter version is more common for me, and when I say I hear voices, the next question is always what do they say. But it’s kind of like if you’re sitting in a crowded restaurant, and someone asks you, “What are people talking about?” I’m not necessarily paying attention. There are some words I can’t make out at all. Often there are random noises in the mix. Some voices I might recognize repeatedly, whether or not I can make out what they’re saying. Some things I can barely understand. Random phrases I catch, meaningless, completely out of context. I might be able to tune in to one voice or exchange at a time. (I also sometimes, less frequently, get the random noise without any chatter/voice element.)

Other times, I do hear only one or two voices saying more specific things. People talking about me, at times like when I’m in an empty public bathroom (usually not nicely). An echo of something random I heard or read, or a conversation I had earlier, often repeatedly. Brief back and forths with imaginary versions of people I know, often unpleasant. Someone calling my name (a rather common experience for many people). My characters talking, more to each other than me, isolated from the rest of their world. (My characters more frequently appear to me in other ways that resemble hallucinations, which I discussed more in the types of dissociation post and elsewhere). Or, my thoughts kind of splitting off into a second voice, until I realize I’m not controlling the second voice anymore. So on.

Lights/Blobs

Flickering lights, fireworks, flames, flashes of lightning, cloudlike blobs, often indoors, all colors. Sometimes pretty and easily blocked out, sometimes distracting and encroaching on the center of my vision, especially the ominous dark blobs that sometimes come before the flashback hallucinations.

Music

Music, in general. Especially when I’ve recently listened to the same song on repeat or to a lot of music that sounds similar—my brain will play it, often gradually louder and louder, in a much more real way than having a song stuck in my head, until I next fall asleep and wake up with it faded or gone. (I can also, at other times, kind of do this at will, like it’s a real radio in the background while I do other things.) Certain artists seem to trip it more than others, which sometimes informs my listening choices, and it’s often not ones you’d think of as catchy. (My brain really likes Evanescence, for starters.) I’ve also had a phase for playlists of, say, piano music, lead to days of hallucinations of piano music, no song in particular, just… piano. I’ve had the same happen with ASMR files, though those usually mimic one file in particular. Same for movie soundtracks; my brain just kind of invents music that sounds like it could’ve been from that movie, but wasn’t. I threw a Harry Potter themed party earlier this year and had all the scores playing for several hours… and remixes for several hours more only in my head (louder and louder until I fell asleep). Same for the Star Wars party.

Notifications

Any sound that functions as a notification. Our doorbell, my alarm clock sound, my wife’s alarm clock sound, any familiar ringtone, so on. I’ll hear it once at random (this is also fairly common), or every few minutes for a few hours or so, or I’ll hear it on constant repeat, sometimes for days at a time. Usually starts sometime shortly after I actually heard the sound. Definitely reduces the effectiveness of my actual alarms, so I mix up the sound now and then.

Flashbacks

Hallucinations related to my PTSD, that go beyond the typical flashbacks. Typically the corpse—sometimes this is a distortion of a living person I am actually seeing—sometimes the death smell, and frequently the feeling of maggots, even though I didn’t experience it myself. Easily triggered by seeing anything similar (including in television, certain Halloween decorations, etc.), people staying very still/sleeping (especially unexpectedly), beds (especially white linens, which I mostly don’t use), darkness/shadows/certain black things, and anniversaries related to deaths in the family/those people when they were alive.

Farrah, Farrah’s Void

I’ve talked about Farrah a lot here, but: a golden retriever puppy who appears to me regularly via assorted visual, auditory, and tactile hallucinations that sometimes match up more than others, who seems to represent the part of my brain that wants to be psychotic and creative. She kind of glows and hovers and makes faces that real dogs don’t make, teleports at times, and I’m kind of telepathic with her; it’s like she can think things at me that manifest as kind of auditory hallucinations, and kind of the way you suddenly understand information in dreams. She started appearing around the one year anniversary of my father’s death and has been in and out since. She came with a collar and a name tag; I didn’t choose the name. She’s very reactive to the real environment, but sometimes is in her Void: an endless white abyss in my brain I sometimes visit by varying levels of accident if I dissociate hard enough. I call her my schizophrenia tamagotchi. Sometimes I wish she’d come out and play even more.

Distortions

Distortions of real objects. Flickering, changing colors, sizes, orientation, details, and being off of where they actually are. Think Alice in Wonderland, or the types of hallucinations associated with certain drugs. I gave one specific example under flashbacks. Very, very bad to have while driving, and I already have spatial reasoning issues. Sometimes just makes me look even more clumsy, closing my fingers around the empty space next to something. Especially hard to explain or catch as a hallucination sometimes, since we’ll both see the object itself in some way.

My Types of Dissociation

I’ve realized that when I talk about dissociating, I can really be talking about a number of different experiences. So I decided to categorize and define some of the versions I talk about most often. This is just my experience, not universal; some aren’t even necessarily clinically dissociating at all, but, to me at least, have some kind of resemblance.

Meditative

This one resembles what some people call productive meditation. I experience it most often when I go on my morning walk, adding a repetitive, moving element. It’s not necessarily bad, and I purposefully invoke it for a reason. But, it’s like a form of dissociation to me because it can be very consuming and kind of hard to snap out of. Using the same ritual every morning helps me ease in and out of it at that time, but it can also happen—purposefully or not—at other times. I keep my route very simple, on small streets, and the same every day, because I can get pretty lost in my head for this, which is dangerous in other areas. It usually looks like I’m a little lost in thought, though it’s more like diving into an internal world entirely. It usually involves decision making, planning, or problem solving, whether it’s what I want to work on that day, what my next larger goal should be, or what I should do about (or if I should do something about) a problem. Ends more smoothly if I’m done thinking on the topic and have written down any takeaways for later, otherwise I remain very consumed by finishing my loose ends, or keeping track of those takeaways.

Telling a Story

This one kind of feels like productive meditation, except it’s less so on purpose. It can also happen during my walks, pretty commonly on the swingset, and at other times. It’s not necessarily bad, though it’s not very productive, either, and again, consuming and hard to snap out of, though a little less so. This one involves mentally telling a story to a usually ambiguous audience. Sometimes things like blog posts are born of this, but oftentimes it’s random anecdotes (or a connected collection of them) from my past, or a recounting of something I’ve written/media I’ve consumed. It’s kind of like Drunk History, except sober, inside my head, and of personal stories or media. I get very sucked into the story. Often comedic, sometimes touching. If it’s a retelling of something I’ve written (or sometimes other media), characters may join in the narration. Sometimes I’ll laugh out loud, gesture, and make other matching expressions for this. Ends when the story ends, kind of, though it might loop or expand.

Daydreaming

This is where the story actually happens. This one strikes me pretty much everywhere, on purpose and, frequently, not on purpose, and is probably the most frequent type. Not always bad, though I do write a lot of doom and gloom, angst and tragedy (and even more stays just in my head), and sometimes it’s not a great coping mechanism, a form of escapism. This one is especially consuming and hard to snap out of. The real world pretty much goes away entirely, and I at least see and hear (and frequently other senses) as if I’m a fly on the wall in my fictional worlds, or my characters. It often functions much more like a hallucination than a visualization (I also sometimes react in real time as if it is—my eyes track motion or mimic characters’ eye movements, so on—or go completely blank); most maladaptive daydreaming descriptions fit, but it still feels like… more. While arguably the most disruptive to my life, I wouldn’t give this one up for the world. As a fiction writer, this is where the magic happens.

Thought Loop

When I get kind of stuck in a thought loop of some kind. This could be a general anxious thought, a ritual, or an eating disorder thought train. I really noticed this the other day while my wife and I were getting ready to leave the house. I realized that in the external world I was standing there, still, silent, staring blankly at nothing, long enough my wife was like, “… ‘Kay. I’ll go cool the car down.” It frequently looks like this, or you might see mumbling/counting on fingers, or actually doing the actions, sometimes anxiously or repetitively. What was going on in my head, however, was mentally running through my leaving the house rituals. I have many rituals like this, for everything from leaving the house to cleaning the kitchen, and they have a hard time changing. I later explained to my wife that one bullet point I had in my head, for leaving the house, was the word dogs, which meant that I should give the dogs their treats before I leave. We don’t have dogs. This bullet point comes from when my mom and I lived on our own in a rental house briefly after my parents’ divorce, and I would give our two dogs some treats before I went on a walk to the park… eight years ago. At least one of those dogs is dead now, and probably both. Still, my mental rituals change on years of delay, with a lot of conscious work if I really feel the need to put it in, so, in that moment, I had to check gave the dogs their treats off in my head (several times, as I frequently go through all of my related rituals until I’ve reached something not checked off, do that thing, and then start over, then go through them like twice after everything has been checked off). This can be brief, but completely consuming, and I get much more anxious if I am pulled away from in it any way. In a way, I can’t function without this, but due to the rituals not being malleable, and how many times I have to go through them, it’s mostly unproductive. I’m currently trying to focus on having the important parts written down, and looking at those lists a reasonable amount, not going through old rituals in my head over and over.

Blank/Zoned Out

The one where nothing’s going on in my head. You see the blank stare, and that’s actually all there is. I don’t get it a lot, and this tends to be a stress response, so it’s almost nice when it does happen, a reset to neutral, though it’s ultimately escapism. I might also just be that tired. Everything goes away. I could live without it, and it’s not the most common, though it’s often what people assume is going on when I get the blank stare. Completely consuming and hard to snap out of. Hard to do on purpose, and I generally don’t. Frequently goes with being nonverbal (or at least serious flat affect/monosyllabic responses) and/or catatonic. Frequently ends in sleep.

Sensory Overload

Occurs when I’m in sensory overload. Not much is going on in my head typically—distracted attempts at escapism or coping, generally, or really, really trying to focus. I might look jumpy and distracted, frustrated, or somewhat catatonic (or be actually trying to escape the onslaught, closing my eyes, covering my ears, etc.). Could definitely live without this one. Less so consuming and moreso distracting, can’t really engage when I’m in it. Frequently renders me nonverbal. Never on purpose. Breaks only when I escape whatever’s causing the sensory issue for a while, usually after a bit of lag.

Active Delusion

Occurs when I am in the grips of a new/active delusion. Somewhat rare with meds and all. Most common subtype might be more of a depersonalization—like looking in the mirror, sometimes literally, often not, and thinking, Is that really me? The only thing in my mind is usually thinking through the delusion—sometimes leaning away from it, trying to logic myself out of it, other times, building it up, defending it, finding out what it is. I tend to be talking about it, very quickly, or possibly catatonic/nonverbal. Mostly not in touch with reality. Could definitely live without this one, too. Never done on purpose. Completely consuming, very hard to snap out of. Solved mostly by time and sleep. Delusions have been about anything from believing in the existence of magical notebooks to believing neither my wife nor my usual pharmacy existed.

Depression Urges

Rare, kind of. Occurs in phases. Happens when I feel extremely depressed, usually in a more anxious way. Looks like: desperately trying to self harm, or else very twitchy if I’m trying to resist, possibly trying to distract myself. Might do anything from laugh to seem frustrated. On the inside, there’s the obsession, usually racing and anxious thoughts, existential, that sound like depression. (The psychologist who gave me my diagnoses had a theory that I never had depression at all, only anxiety, and I see where she’s coming from when I examine what these thoughts look like.) Yeah, could live without this one, but it’s also weird to think about my personality without it, or without where it comes from, at least. Not done on purpose, though it might look like it; I’m not really me when it’s full blown. Consuming, hard to come out of on purpose, but I tend to snap out of it abruptly and within a few hours at most. If I do succeed in self harming, it stops, though it usually turns into something like Blank/Zoned Out.

Hallucination/Flashback/Waking From Nightmare

When I am partially consumed by something that isn’t real. This type varies wildly, really, but I couldn’t think of any further ways to break it down. Happens in phases, overall somewhat frequent. Not done on purpose. Might look anxious/scared (sometimes visibly shaking), distracted, twitchy/jumpy, staring at a certain spot, overall reacting to seemingly nothing, or suddenly zone out briefly and repeatedly. Could largely live without this one. I’d keep the dog, I guess. Partially to totally consuming, sometimes responds well to distraction, or will fade with sleep/time. I might be going somewhere else entirely (the dog’s/Farrah’s white void she hangs out in, the whole scene of my trauma, back into the nightmare) or seeing something projected onto the real world (corpse, dog, etc.) Could also involve other senses, especially auditory (voices, music, etc.) and tactile. Sometimes terrifying, sometimes amusing, sometimes just distracting or unnerving. I have another post in mind about most common hallucinations…

This Is For

This is for the people I shared seventy-two long hours with

We’d never met before nor would we ever meet again

None of us wanted to be trapped within those white, white walls

Yet we were all hiding from something out there, too

This is for them: the crazy, the broken, the silenced

This is for the roommate I got on my second night, first full night

She was blonde, maybe forty, and if we weren’t in a psych ward

I think she might have been pretty

But we were

And she looked like death

She was detoxing from a drug cocktail from nightmares

And neither of us slept

Since they had to check on us every five minutes

With lights in our faces all night

The same drugs that got her here killed her boyfriend

But she was here to tell me the tale

And we swapped our stories, and she said,

“Oh, honey, you don’t belong in here,”

And she told me that I had things waiting for me outside these white, white walls,

That I should listen to my parents,

And if I wanted to write, then maybe I should write

(And I am)

But no matter what, and I followed this advice, too,

“Don’t touch drugs, and don’t come back.”

This is for the girl with the dark, glossy, staring eyes

That might sound bleak, but she was always smiling, giggling

Her mind was somewhere else, like mine

She was schizophrenic, too,

She’d been there a while,

She told us in a group session that she fell in love with the boy only in her mind

That she believed he would want the best for her, even if it meant his demise

But she just wasn’t so sure she wanted to give him up

And I told her I had friends only in my mind, too

And that maybe the ones we really love never truly leave us, real or not real

And medication didn’t have to take that away from her

That he’d still be there if she wanted him, but only if she wanted him

But so would the real world now, if she wanted it

And later, I told myself that when I went back on meds,

This thing I said first just to comfort her,

But at that moment, she giggled again, and looked at peace, and said,

“Thank you.”

This is for the boy who talked nonstop

He had a sweet, sweet car and a sweet, sweet girl

He couldn’t wait to get out and see them both

He told us this over and over and over

And there probably was no car

And there probably was no girl

But God, it was nice to live in his world for a second

He smiled every day over a breakfast a saint couldn’t eat

And didn’t mind that you couldn’t truly use the bathrooms alone

He was a regular, knew all the staff’s first names

But didn’t look over at the sound of his own

And he told us how great the world was out there

And I wanted to believe him

And when they let us walk around the gray courtyard in circles

For fifteen precious minutes

Instead of hallways paced so much, all night, they put up signs

Telling you how many laps was a mile

I didn’t go outside, because it was pouring

But he went, and he came back in, soaked, radiant

And I asked about the weather, joking, and he told me:

“It’s so beautiful.”

This is for the one who tried to escape

I saw what he was doing

I cheered him on in my head and looked away,

Don’t give him away,

He crouched down low below the nurse’s station

And quietly bolted after someone into the locked room

The one with the elevators

But he got caught

And all I could think about was what I would’ve done

If I’d done it, made it to the first floor

No shoes, no jacket, no wallet, no keys, no phone

They’d taken all of those things away

I would’ve had only the same clothes I arrived in days ago

I wondered if I could’ve blended in enough to walk out the hospital’s front door

And then gone… where?

And I still ask myself that years later,

And they asked him questions, right then, right there,

In that white, white hall that told you how many times you had to pace them

To get to a mile

(So many)

And, bitter, he told them,

“Well, it was worth a shot.”

This is for someone I don’t know

It was one of us, it could’ve been any of us

But I got to borrow one of the hospital’s tablets

To check my school email

And feel like there was still a world waiting for me outside

And right there in the search history

Was a question we’d all pondered

Yet I couldn’t bring myself to find out the answer

I didn’t want to be a tattle

But I didn’t want to have someone’s life on my conscience

Even though I’d asked myself the same question

And I remembered craving death

The way you’re supposed to crave oxygen

Every second without it throbbing

I swallowed too many of my antidepressants once

I regretted it

I liked to think there really was a worthwhile world out there

So I told the nurses, just in case

The person I didn’t know

Had found the answer to,

“How do you kill yourself in a psych ward?”

This is for the woman who was admitted after me

I overheard them saying she had anger issues, she was delusional

That communication was hard, they said she spoke poor English

She screamed at them that English was her first language,

That they just didn’t like that she had dark skin,

That she wasn’t born here,

That her accent didn’t sound like theirs

She liked to yell and throw and punch

And I was stupid or brave enough to ask her what was wrong once

And she told me she was mad at what the US government had done to her home country in Africa

And I told her that wasn’t so delusional, that she was right to be mad

And for what it was worth, I wasn’t so fond of what they’d done to this country, either

And she took a deep breath and she told me,

“You seem sane. Don’t stop.”

This is for the girl who liked to color with me in silence

We weren’t supposed to talk about where we came from

But I thought I heard her slip and say something about Harvard

It was around midterm time, then, for both of us

She had scars running up her arms that might scare the average soldier

But she made beautiful drawings, with or without lines to color in

And she doodled hearts over those scars until they faded away

She just missed her dog, and her mother’s cooking,

And she had a little sister she was scared would turn out just like her

She didn’t say much, but we’d sharpen our pencils under supervision together

With a cheap little plastic pencil sharpener from a back to school sale

And I mumbled something about the times I’d taken one of those apart because

I had nothing else to take out my self hatred with

In the same breath as complaining about being watched,

And it was sad, unhinged, shameful,

But what really made me not want to do it again

Was when she looked at me with the expression she got

When she talked about not wanting to scar her sister’s wrists

With her own self loathing, and she said,

“Same.”

This is for the people I shared only seventy-two long, unwilling hours with

Complete strangers, yet no matter how different we seemed from each other

We shared how much the rest of the world wanted to lock us away

And how much a part of us wasn’t quite of that world

And we did better united than divided

And if I have to be honest

They sure did me a lot more good than the doctors did.

Tracking the I’ll Give You Series vs. My Mental Health at the Time

I wrote a post a while back: “Tracking Contrivance vs. My Mental Health at the Time,” an exercise in tracing changes in my writing versus changes in my mental health.

For this post, I’m doing it again, with the emphasis on the I’ll Give You series.

(Note: this post was updated to go through the current month, after the original post.)

May 2020

It’s been most of a year since the whole “my father died suddenly at fifty-eight and I found his ten day old corpse in his house” thing. I seemed to be over the worst of the trauma response for a little while, but the pandemic struck full force two months ago, reports about overstuffed refrigerated trucks dominating the news. My grandmother passed just days ago at home in hospice care; I arrived just moments after her death to sit with family.

I’ve spent most of a year buried in Contrivance, my dark, primary original fiction project of most of a decade, writing instead of sleeping. My fear of beds—too many bodies in too many beds, memory and flashback and nightmare and hallucination—is so bad, I’ve taken to sleeping on the floor in the loft (after scaring the daylights out of my best friend—now our quarantine roommate in the guest room—by unexpectedly sleeping on the couch, in the house we closed on the first day of March). I’m not on meds, and I’m Zooming my therapist weekly. The world is burning. I just got engaged.

And I need less doom and gloom.

The idea for a new writing project is slowly taking shape. Daydreams—erotic and otherwise—start to take real shape, the same characters, situations, themes, showing up again and again. I could use a distraction, a little side project. Maybe eighty-thousand words, I tell myself, a few months, one book. Just a detour while I figure out a few things about my real writing love, Contrivance. (It’s not you, it’s me. Maybe we just need a break.)

I start hashing out character basics, scroll Zillow for setting inspiration, combining random ideas into a plot. I sit on the couch and talk it all out with my best friend, also a writer in need of distraction.

I’m taking an online writing workshop, and our prompt for a freewrite one day is company from out of town could mean trouble. I misinterpret it slightly—though the instructor stresses that it’s open to interpretation—and a plot is born, an enemy, a cause, an ending to the story.

I start writing for real, and it’s like a dam bursting. I struggle with titles for a bit, but eventually settle on I’ll Give You Everything I Am (You’ll Give Me Everything I Want to Be). And I start posting it on Archive of Our Own to a silent reception for a full five chapters, because why not?

July 2020

I am still writing like crazy—even winning Camp NaNoWriMo, writing over fifty thousand words in July alone—though I dropped out of the more structured writing workshop. (I finished a shorter one on dialogue, and I notice that this project’s dialogue is much more relaxed, natural, than in Contrivance, something I want to take with me to my edits.) I’m also picking up a bit of an audience, which is exciting, and a little nervewracking—I’ve never really written erotica before, not even something centered on romance.

I’ve also picked up two tricky, additional main characters, whom I battle with—they want to throw grenades at my plot, and I would like them to go away and leave my three-month, eighty-thousand word, one-book side project alone. I retcon them out of past chapters where they’re not strictly needed only for them to pop up again, more significantly, later, until we’re seriously throwing the word polyamory around.

I’m spending a lot of time at the park, on the swingset in triple digit heat, listening to music and trying to figure this project out. Who on Earth are these two, and where do they fit into my beautifully simple, tiny project?

And so Jen and Clara are born.

Meanwhile, my mental health isn’t going so well. I’m hallucinating regularly—mostly Dad, dead, and, of all things, a mysterious golden retriever puppy named Farrah. I’m catatonic for hours at a time, occasionally delusional, and generally a mess.

I also start this—The Schizophrenia Diaries—because I sure have mental health things to talk about. I’m still maintaining my older blog—more alternative sexuality education—too, and that’s now picking up attention from my erotic fiction audience.

My therapist thinks I should go back on meds, but I can’t even get in to my old psychiatrist.

Everyone is a mess right now.

August 2020

I’ve accepted—mostly—that Jen and Clara exist. In Chapter Fourteen, Clara tells Lalia a story that just begs for more, about a time she ran away. In the middle of the night, in the dark, I fire up a new document and title it bluntly “The Night That Clara Ran Away”, a title which oddly sticks permanently, and has a few more stories titled in something like parody, like the later “The Night That Clara Just Wanted to Sleep” and “The Night That Evan Ran Away.”

So I begin writing companion stories.

September 2020

I’m back on meds, and it’s mostly great. I’m sleeping at night, and all but bouncing with energy during the day. I stop seeing my therapist. My best friend moves in with my mom, and I get my own swingset in the backyard. Vaccines are on the horizon, my wedding is in two months. I’ve been posting Contrivance bits on their own website. A neurologist rules out the idea that I’m having seizures.

In that process, I’m required to do a sleep deprived EEG. So I pull an all nighter. My appointment also happens to be right after Yom Kippur. So I start fasting at sundown, sleep, fast for about twenty-six hours total, eat dinner, and then stay up all night, snacking, and have my morning appointment and then a full afternoon and evening awake, for a total of thirty-eight consecutive waking hours.

If one wasn’t psychotic at the start of that, they would be by the end.

And, y’know, I was schizophrenic to start with.

In the middle of the all nighter, I create a Discord server to chat with myself, like a normal person, figuring out I’ll Give You plot bits. In that crazed night, the plot of what becomes Book Two—by now I’ve accepted a Book Two is coming—is born.

November 2020

I get married. It is one of the best days of my life, and another one is close on its heels.

I finish what I now acknowledge is only Book One of what I’ve hesitantly started to call the I’ll Give You series/trilogy, and, for fun, have a few copies vanity printed for me and friends. But now that I’ve put all the formatting work in… why not self publish?

So I do. It’s surreal, to hold a published book that arrived in the mail, with hundreds of pages, a real cover, a summary on the back along with reader reviews, a dedication page with my wife’s name on it, and my (pen) name on the front.

But… that looks like a book, my mom says when I send her a picture. She had a vague understanding that I was posting erotica online after my best friend blurted it out at dinner, but is surprised—as am I—by the almost four hundred page hardcover in my hands.

Yeah. My quick little side project, indeed.

To my shock, people who aren’t my mom even buy it.

December 2020

Encouraged, I start posting Contrivance in the same manner—serially, in order, as a book, on Archive of Our Own. It doesn’t get quite the same engagement, which is funny to me—Contrivance is still my precious baby in a way, not the I’ll Give You series, but that’s okay. Sex sells. I accept that. I’m also accepting I might actually know something about these things I’ve been writing about, and schedule my first classes as an alternative sexuality educator.

I think I’ve just about got things figured out—I know how Jen and Clara fit into my no longer so simple plot, I know how I like to post things, I know how self publishing works, I know what has an audience, I know how to talk to my mom about it, I know what’s coming in Book Two—and then, Clara tosses another grenade.

She has an eating disorder. Anorexia, specifically. Well, mostly recovered, but it’s been there this whole time.

And… it has. It’s there, all right—in every time we see her interact with food. It’s there, every time she might want a coping mechanism. It’s there, in the way she looks in the mirror, in the way she lives in the dance studio, in her penchant for self destruction. It’s there, in the former perfectionistic, traumatized teenager without a mother. It’s been there.

So I do some research, and I make it work.

February 2021

This whole writing companions thing is kind of out of control, and now there’s a book’s worth of them, and I publish The First IGY Companion as almost an accident.

I’ve started teaching webinars, I’ve started going to butler school. Other areas of my life are picking up—not just hunkered down writing.

May 2021

I take a little staycation, a few day writing retreat alone at a nearby hotel, using rewards points that we got to keep through the pandemic.

I don’t take care of myself well, though, too lost in my words. My mental state spirals, and I self harm for the first time in many years.

Interestingly, the chapter I’m writing is the one where the main character, Lalia, tries blood play for the first time.

My wife takes me home early, and I recover quickly.

July 2021

By now, I’m running Las Vegas TNG, a local alternative sexuality group, and I publish Service Slave Secrets (Volume One), the first years of my blog on the subject, to a nice reception.

Book Two—I’ll Give You Everything I Want to Be (You’ll Give Me Everything I Need to Be)—is flowing, as everyone unpacks their issues in and out of therapy.

I try going off my meds briefly, gradually cutting down with the thought that I’ll stop when it starts to affect my sleep, as that’s the easiest way to measure the minimum dosage. However, my sleep doesn’t really suffer, but I abruptly realize, five minutes overdue for the first dose I’ve totally skipped, that I’ve been absolutely miserable, and can’t hear my own thoughts over the music hallucinations I mistook for a song stuck in my head, among others.

I go back to the full dosage that night.

November 2021

Several months into the “health kick” that’s taken an especially dark spiral recently—hint hint, healthy diets don’t include this much purging and fasting and overexercising—I accept that I have an eating disorder—all of the symptoms of anorexia, not quite underweight—and start the cycle of on again off again commitment to recovery. I don’t need to weight restore, but this cycle has got to stop. I start to talk about it with the people close to me, and write a post in which I theorize about where it came from:

Clara.

It’s been almost a year since my abrupt realization that Clara had an eating disorder, and I am now detangling my thoughts and hers. I write a post on this—the dangers of writing a character with a disorder I don’t have, as a schizophrenic author with a very fine line between character and self.

At some point in my research, the tables turned. Now I’m writing backstory companions to pour what my head sounds like onto paper—this many calories eaten, this many hours left to fast, this many pounds, BMI this, BMR that, that many minutes of exercise—thoughts that weren’t mine when I started.

I write about how I took an online eating disorder assessment as research early on, and got a very safe, normal score. Now, though: yup. Something’s not right.

Which came first? Was I already developing disordered eating habits, projecting them onto a character until I couldn’t deny it was me anymore? I’m convinced that the character’s disorder came first, but we’ll see.

Incidentally, I finish and publish Book Two instead of winning NaNoWriMo.

March 2022

I publish The Second IGY Companion along with Contrivance in the same hectic week, having recently finished my first (posted) AU for the I’ll Give You series: “Let’s Not Be Star Crossed Lovers”, a short multichapter of alternate backstory.

I’m also finally learning to drive, hallucinations under control, which is always an emotional roller coaster.

Book Three—I’ll Give You Everything I Need to Be (You’ll Give Me Everything I Am)—continues on.

It’s certainly an interesting month. I’m still bouncing back and forth on the eating habits, now with my wife’s help supervising three meals a day for a while, starting to sort out my disordered thoughts around food, focusing on the fact that skinny seems to represent productive for me, and that I’m actually more productive if I just suck it up and eat.

August 2022

Book Three is still in progress, flowing along. A few companions have gone up, but they’re slowing down, and I’m thinking of editing them into a future edition of The Second IGY Companion rather than creating a third. I have at least one more AU going on in my head to write.

I’ve gotten into hiking in the last few months, started donating plasma, and started a Little Free Library, and have been working on my newest blog, A Productive Hannah, and am eyeing a brewing sequel to Contrivance.

I publish Service Slave Secrets: Volume Two, breaking my personal royalty records.

August is a hard month for me, though. I’d like to blame it on hormonal, non psychiatric med changes, but I’m not sure. Right on the heels of some major anniversaries involving my father’s birth and death, symptoms, especially the eating issues, flare, and burnout threatens.

I take a week of vacation in Boston, and pledge to take September off from events.

October 2022

I’m back to events, but we’ve gotten into camping, a welcome reprieve from most of the world. I’m trying to find balance, and overall, my events and writings are going really well. I’m really feeling what’s going on in Book Three, and soon to publish The Schizophrenia Diaries.

We’ll see what the future holds.